Provider Demographics
NPI:1932646049
Name:SCOTT COUNTY COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:SCOTT COUNTY COMMUNITY HOSPITAL, INC.
Other - Org Name:BIG SOUTH FORK MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEFTWICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-286-5307
Mailing Address - Street 1:18797 ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-2127
Mailing Address - Country:US
Mailing Address - Phone:423-286-5301
Mailing Address - Fax:423-286-5306
Practice Address - Street 1:18797 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2127
Practice Address - Country:US
Practice Address - Phone:423-286-5301
Practice Address - Fax:423-286-5306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access